Association b/t Gastrointestinal angiodysplasia and severe aortic stenosis (Heyde's syndrome) !
It is due to the induction of von Willebrand disease type IIA by the valvular stenosis
13C-Hiolein (highly labelled triolein) breath test reflects impaired lipase output and indicates decompensated lipolysis (in other words, pancreatic exocrine function). The 13C-Hiolein breath test is a convenient alternative to faecal fat analysis.
It can be used to monitor the efficacy of pancreatic enzymes therapy.
The 14C-xylose breath test a highly specific and sensitive test of bacterial overgrowth in the small intestine.
The gold standard investigation of bacterial overgrowth is small bowel aspiration and culture
Other possible investigations include:
hydrogen breath test
14C-glycocholate breath test: used increasingly less due to low specificity
Tx - Rifaximin (also used in traveler's diarrhea (E.coli) and Hepatic encephalopathy
interferes with transcription by binding to the β-subunit of bacterial RNA polymerase
Alternative - Co-amoxiclav or Metronidazole (others - tetracycline, neomycin, bactrim, etc.)
The most common cause of free intraperitoneal air in an adult?
iatrogenic - usually resolves in 3-7 days but may persist for up to 4 weeks
The most common spontaneous causes (in order) --